Barriers and myths that limit the use of intrauterine contraception in nulliparous women: a survey of Brazilian gynaecologists

Silva-Filho, Agnaldo L.; Lira, Josefina; Rocha, Ana Luiza Lunardi; Carneiro, Márcia Mendonça

doi:10.1136/postgradmedj-2016-134247

Cited by 10 publications

(7 citation statements)

References 27 publications

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“…Addressing/dispelling myths and misconceptions among youth is particularly important for future contraception use. By nature of originating in social networks as well as their likelihood to ‘stick’ indefinitely, myths and misconceptions among youth should be dispelled early to prevent their becoming engrained 6 41. Indeed, our study found that two of the three most commonly-believed myths and misconceptions among youth age 18–24 years (people who use contraceptives end up with health problems, and contraceptives can harm a woman’s womb) were also the top myths for youth and adult women aged 15–49 years in Kenya, Nigeria and Senegal 9…”

Section: Discussionmentioning

confidence: 99%

Busting contraception myths and misconceptions among youth in Kwale County, Kenya: results of a digital health randomised control trial

et al. 2022

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ObjectivesThe objective of this randomised controlled trial in Kenya was to assess the effect of delivering sexual and reproductive health (SRH) information via text message to young people on their ability to reject contraception-related myths and misconceptions.Design and settingA three-arm, unblinded randomised controlled trial with a ratio of 1:1:1 in Kwale County, Kenya.Participants and interventionsA total of 740 youth aged 18–24 years were randomised. Intervention arm participants could access informational SRH text messages on-demand. Contact arm participants received once weekly texts instructing them to study on an SRH topic on their own. Control arm participants received standard care. The intervention period was 7 weeks.Primary outcomeWe assessed change myths believed at baseline and endline using an index of 10 contraception-related myths. We assessed change across arms using difference of difference analysis.ResultsAcross arms, <5% of participants did not have any formal education, <10% were living alone, about 50% were single and >80% had never given birth. Between baseline and endline, there was a statistically significant drop in the average absolute number of myths and misconceptions believed by intervention arm (11.1%, 95% CI 17.1% to 5.2%), contact arm (14.4%, 95% CI 20.5% to 8.4%) and control arm (11.3%, 95% CI 17.4% to 5.2%) participants. However, we observed no statistically significant difference in the magnitude of change across arms.ConclusionsWe are unable to conclusively state that the text message intervention was better than text message ‘contact’ or no intervention at all. Digital health likely has potential for improving SRH-related outcomes when used as part of multifaceted interventions. Additional studies with physical and geographical separation of different arms is warranted.Trial registration numberISRCTN85156148.

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Section: Discussionmentioning

confidence: 99%

Busting contraception myths and misconceptions among youth in Kwale County, Kenya: results of a digital health randomised control trial

et al. 2022

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“…The intervention group assignment, self-assessed competency score, as well as number of reported LARC procedure experiences during medical school were all associated with various skill scores. The need to improve contraception knowledge, especially LARC, among medical students has been recognized in LMICs [1][2][3][4][5][6], but without documented effective strategies. In the United States, a prospective study of students at seven medical schools found that IUD knowledge increased significantly after completion of a clinical rotation in Ob-Gyn [13].…”

Section: Discussionmentioning

confidence: 99%

“…Across the globe, accessing the most effective family planning (FP) methods, especially long-acting reversible contraceptives (LARC), requires trained providers. However, studies from low-and middle-income countries (LMICs) suggest that medical students are often unprepared to provide these services because of misconceptions or lack of training [1][2][3][4][5][6]. This training gap delays the ability to address this important women's health need.…”

Section: Introductionmentioning

confidence: 99%

Structured integration of family planning curriculum: comparative assessment of knowledge and skills among new medical graduates in Ethiopia

et al. 2018

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“…[16,17]. Concern about insertion pain may also be a barrier for gynecologists to consider the IUD as a contraceptive option, especially for nulliparous women [18].…”

Section: Introductionmentioning

confidence: 99%

Use Of Naproxen Versus Intracervical Block For Pain Control During The 52-MG Levonorgestrel-Releasing Intrauterine System Insertion In Young Women: A Multivariate Analysis Of A Randomized Controlled Trial

Oliveira

Baêta

Brant

et al. 2021

Preprint

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Background: To compare the effectiveness of oral analgesia with 550 mg naproxen sodium versus local anesthesia with 6mL 2%-lidocaine intracervical block in pain lowering at the 52-mg levonorgestrel-releasing intrauterine system (LNG-IUS) placement in young women. Methods: In this randomized controlled trial, 100 women aged 15-24 years were block-randomized to receive either 6mL 2%-lidocaine intracervical block 5 minutes before the LNG-IUS insertion or 550 mg naproxen 30 minutes before the procedure. Forty-nine women received oral naproxen and 51 received intracervical block. The primary outcome was pain at LNG-IUS insertion. Secondary outcomes were ease of insertion, insertion failures, and correct IUS positioning. Neither participants nor doctors were blinded. Pain at insertion was assessed by using a Visual Analog Scale (VAS). Results: Women randomized to lidocaine intracervical block presented lower mean pain score at insertion, when compared to women who received oral naproxen (5.4 vs. 7.3, respectively; p <.001). Parous women had a 90.1% lower chance of experiencing severe pain (p=0.004). There was a 49.8% reduction in the chance of severe pain for every 1-centimeter increase in the hysterometry (p=0.002). The only complication observed during insertion was vasovagal-like reactions (7%). The insertion was performed without difficulty in 82% of the women. Participants in the intracervical block group presented higher proportion of malpositioned IUS on transvaginal ultrasound examination compared to women in naproxen group. Nevertheless, all the malpositioned IUS were inserted by resident physicians. Conclusion: Lidocaine intracervical block was found to be more effective than oral naproxen in reducing LNG-IUS insertion pain. Trial registration number: RBR-68mmbp Brazilian Registry of Clinical Trials Retrospectively registered (August 4, 2020) URL of trial registry record: https://ensaiosclinicos.gov.br/rg/RBR-68mmbp/

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Barriers and myths that limit the use of intrauterine contraception in nulliparous women: a survey of Brazilian gynaecologists

Cited by 10 publications

References 27 publications

Busting contraception myths and misconceptions among youth in Kwale County, Kenya: results of a digital health randomised control trial

Busting contraception myths and misconceptions among youth in Kwale County, Kenya: results of a digital health randomised control trial

Structured integration of family planning curriculum: comparative assessment of knowledge and skills among new medical graduates in Ethiopia

Use Of Naproxen Versus Intracervical Block For Pain Control During The 52-MG Levonorgestrel-Releasing Intrauterine System Insertion In Young Women: A Multivariate Analysis Of A Randomized Controlled Trial

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